Right Extended Split Liver Transplantation Compared With Whole Liver Transplantation: Lessons Learned at a Single Center in Latin America—Results From a Match Case-Control Study

Gambaro, Sabrina Eliana; Romero, Pablo Ramírez; Pedraza, N.; Moulin, L.; Yantorno, Silvina; Ramisch, Diego; Rumbo, Carolina; Barros-Schelotto, P.; Descalzi, Valeria; Gondolesi, Gabriel

doi:10.1016/j.transproceed.2017.07.019

Cited by 8 publications

(12 citation statements)

References 31 publications

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“…1). Only studies that clearly described the splitting techniques, evaluated outcome of ERL liver grafts compared with WL grafts, and did not analyze overlapping collectives were eligible for analysis of ERLT and WLT outcomes [6,15,18,19,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45]. Despite the high quality, the study of Adam et al did not provide precise definition of the splitting liver technique and their study was therefore excluded from the analysis [46].…”

Section: Study Selection and Selection Criteriamentioning

confidence: 99%

“…In four studies bias reports were inadequate [18,33,35,40]. Eleven studies did not report bias [19,30,32,34,36,38,[41][42][43]47,48]. None of the included studies reported on prospective sample size calculation and number of patients lost to follow-up.…”

Section: Qualitative Analysismentioning

confidence: 99%

“…All included studies were retrospective cohort analyses that were published until December 2020 [6,15,18,19,[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45]. A total of 75 799 adult transplant patients were included in the ERLT meta-analysis, with follow-up ranging from 1 to 240 months (Table 1).…”

Section: Studies and Patientsmentioning

confidence: 99%

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Considering extended right lobe grafts as major extended donor criteria in liver transplantation is justified

et al. 2021

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Summary The outcomes of split‐liver transplantation are controversial. This study compared outcomes and morbidity after extended right lobe liver transplantation (ERLT) and whole liver transplantation (WLT) in adults. MEDLINE and Web of Science databases were searched systematically and unrestrictedly for studies on ERLT and its impact on graft and patient survival, and postoperative complications. Graft loss and patient mortality odds ratios (OR) and 95% confidence intervals (CI) were assessed by meta‐analyses using Mantel–Haenszel tests with a random‐effects model. Vascular and biliary complications, primary nonfunction, 3‐month, 1‐, and 3‐year graft and patient survival, and retransplantation after ERLT and WLT were analyzed. The literature search yielded 10 594 articles. After exclusion, 22 studies (n = 75 799 adult transplant patients) were included in the analysis. ERLT was associated with lower 3‐month (OR = 1.43, 95% CI = 1.09–1.89, P = 0.01), 1‐year (OR = 1.46, 95% CI = 1.08–1.97, P = 0.01), and 3‐year (OR = 1.37, 95% CI = 1.01–1.84, P = 0.04) graft survival. WL grafts were less associated with retransplantation (OR = 0.57; 95% CI = 0.41–0.80; P < 0.01), vascular complications (OR = 0.53, 95% CI = 0.38–0.74, P < 0.01) and biliary complications (OR = 0.67; 95% CI = 0.47–0.95; P = 0.03). Considering ERLT as major Extended Donor Criteria is justified because ERL grafts are associated with vasculobiliary complications and the need for retransplantation, and have a negative influence on graft survival.

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Section: Study Selection and Selection Criteriamentioning

confidence: 99%

Section: Qualitative Analysismentioning

confidence: 99%

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Considering extended right lobe grafts as major extended donor criteria in liver transplantation is justified

et al. 2021

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“…La dificultad de la BH derecha/izquierda está relacionada con las variaciones anatómicas del hígado, la falta de estructura anatómica que defina el plano de sección parenquimatoso, el TIF prolongado (casos de BH ex situ), dificultades en la distribución y la necesidad de un equipo entrenado en cirugía hepática [8][9][10][11] . La mortalidad en LE es una de las causas que nos motivaron a realizar esta BH.…”

Section: Cirugía De Implante Del Injerto Derechounclassified

“…The difficulty of the full-right full-left splitting technique is related to the anatomical variations of the liver, the lack of an anatomical structure defining the parenchymal resection plane, the long CIT (in case of ex situ SLT), difficulties in the distribution and the need for a team trained in liver surgery [8][9][10][11] . Waiting list mortality is one the reasons that motivated us to perform this SLT.…”

Section: Implantation Of the Right Graftmentioning

confidence: 99%

Factibilidad de la bipartición hepática derecha-izquierda in situ en el trasplante hepático

Schelotto¹,

Mercado²,

Pattin³

et al. 2019

Rev Argent Cirug

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Due to the shortage of organs for transplantation, different surgical alternatives have been developed, as split liver transplantation (SLT) and living-donor liver transplantation. In classical SLT, the liver of a cadaveric donor is divided and two allografts are obtained, one corresponding to segments 2-3 and the other to segments 1, 4–8. In order to produce two grafts from one liver for two adult recipients, splitting of the liver can create a right graft including segments 5–8 and a left graft with segments 1–4. Splitting of the liver can be performed during procurement (in situ) or on the bench (ex situ). The aim of our study is to describe the first case of in situ full-right full-left split liver transplantation, with focus on donor and recipient surgery.

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Addressing the challenges of split liver transplantation through technical advances. A systematic review

Lau

Jacques

McCaughan

et al. 2021

Transplantation Reviews

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Right Extended Split Liver Transplantation Compared With Whole Liver Transplantation: Lessons Learned at a Single Center in Latin America—Results From a Match Case-Control Study

Cited by 8 publications

References 31 publications

Considering extended right lobe grafts as major extended donor criteria in liver transplantation is justified

Considering extended right lobe grafts as major extended donor criteria in liver transplantation is justified

Factibilidad de la bipartición hepática derecha-izquierda in situ en el trasplante hepático

Addressing the challenges of split liver transplantation through technical advances. A systematic review

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